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  ÿave the client void immediately efore surgery.
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Period in the health care continuum that focuses ÷ %   
 

   
merely on the time of surgery until the recovery of    
the patient. Fear of the unknown
÷   

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Notify the surgeon
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Urgent Stand y her side and quietly ask her to descri e
her feelings
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Urgent       
³Can you share with me what you¶ve een told
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Done to relieve symptoms or improve function it reflects the moral values and eliefs that are
 used as guides to personal ehavior and actions


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informed consent |ssess the client for concerns especially those
that can potentially cause pain
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| guarantee of the results of the planned surgery ÷  
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The client must e fully informed regarding ÿow is the post operative pain over the site like?
treatment, tests, surgery and the risks and enefits
prior to giving informed consent ÷ "

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     |pples
Surgeon
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     Bananas
  
  
   
 
  


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O tain telephone consent from a family mem er

and have the consent witnessed y two persons. The use of condoms

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Voluntary, Informed, and Competent   
Cotton pads and silk tape
÷ 
   
       
   
  
          ÷ 0
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|sk the patient what the physician told him and |pply a cloth arrier to the client¶s arm under a
then call if necessary lood pressure cuff when taking the lood pressure.

÷ %  
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| not valid signature | latex allergy

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IV catheter insertion    á áá     
 
³I need to continue to take the aspirin as
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*   prescri ed until the day of the surgery.´
Left Sim¶s position
÷ %      
     
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 ³Does your child have any leeding tendencies?´
Notify physician
÷ 1        
  

÷ %
    
  
   
  During the preadmission visit & the afternoon or
 
   evening efore surgery
Ensure that the client has voided
÷ 2          
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Verify patient identification and informed consent |ssess respiratory rate carefully

÷ %    
  
 
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Place a new identification and on the client¶s Respiration
wrist efore the client can e transported to the OR
÷ %  
 
  
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÷ 2  
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  |lready unconscious, has relaxed muscles and
reduce the acterial content of the colon the surgery is started.

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Cardio-pulmonary system Restrain the patient

÷ %   
      ÷ % 


  General anesthesia
Presence of loose tooth
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   Respiratory depression
      
  
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Cover the wedding and with adhesive tape and ÷  
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tape it to her finger Intravenous and inhalation

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Prevent postoperative infection y reducing the Complaints of headache
num er of microorganisms of the skin.
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       Monitor the client for respiratory
 depression
Clipped     hypotension !  #

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Vital signs Malignant hypethermia

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³ÿas anyone in your family ever had pro lems
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    with general anaesthesia?´
10-15 minutes
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Take a video of the entire intra-operative dantrolene (Dantrium)
procedure
÷ 5

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÷ 5 
    

   Strap made of strong non-a rasive materials are
 
  
 fastened securely around the joints of the knees and
Put side rails up and ask the client not to get out ankles and around the 2 hands around an arm
of ed oard.

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 To prevent the cross-contamination of infection
  

 etween OR staff and patient
|tropine sulfate & scopolamine
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          Prevent transmission of pathogenic
   

  
  microorganisms
Check aseline vital signs
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incision site
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Remains conscious ÿonest adherence to surgical aseptic techniques
all the time
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Motor and sensory function
Transmission of infection during processing is ³a place for everything and everything in its
avoided place´

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Last case X-R| and incidence report

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The circulating nurse can have a direct contact Implement a regular maintenance and testing of
with the sterile field. alarm system
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Pick up the right glove with the left hand covered Check the functionality of the pump efore use
with cuff y grasping the fingers, lifting straight up,
and placing on the right palm side down. ÷ &  )
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÷ "             Integrity and functionality after each use &
From the field, on the ack ta le and outside the processing
field. (FBO)
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 1. Wiping instruments used in the sterile field
     2. pre-rinsing
Change ta le levels according to the height level 3. washing
of the surgeon. 4. rinsing
5. disinfecting /sterilizing
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 (   )  6. wiping for safe handling
When the surgical hair cap is touched.
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÷    . $/ — áᏠ  Rinse with sterile water.
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Restricted area only ÷ 1
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ÿead cap, scru suit, mask, OR shoes
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Sterile gauze ÷ 
   

 

121 degrees Celsius for 15 minutes
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Masks covering the nose and mouth  
Material compati ility and efficiency
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Disinfected Items need not to e cleaned or freed from the
grease and oil.
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Semi- critical items They are oth capa le of sterilizing the
equipments; however, it is necessary to soak
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  supplies in the liquid sterilizer for a longer period of

  
   
 

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Critical ÷ %   9
    
Sterilization y oiling
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Non critical  
  
    

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Sterile instruments ÷ 7 

        
    
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 Bio-med technician

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Sterilized ÷ .  
  
 
   
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   Radiology department


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X-ray technician * 
|traumatic needle
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Surgeon, assistants, scru nurse, circulating ÷ 
 
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nurse, anaesthesiologist 
Staple
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Scru and circulating nurses c  c
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Circulating nurse
Every 15 minutes
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  Every 15 minutes for the first half hour, every 30
        minutes for 2 hours, every hour for 4 hours, and
Circulating nurse
then every 4 hours as needed.
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Circulating Nurse


   
|ssess the patency of the airway.
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Passing an instrument to the surgeon.
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Scru nurse
Extending client¶s chin while on his side and
pillow at the ack
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|ccount for the num er of sponges, needles,
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supplies, used during the surgical procedure.
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Keeping patient NPO until gag reflex returns
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Scru nurse and the circulating nurse



 
       
Gagging
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  OR nurse supervisor
÷ 7
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The ronchial suture line may e traumatized
 
|naesthesiologist
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Provide oxygen as prescri ed

        
|nesthesiologist
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In a lateral position
Surgeon
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The quality of the client¶s respiration
 
  
   
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Who are your assistant and anesthesiologist, and
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what is your preferred time and type of surgery?


Pulse oximeter reading is 80% (| normal)
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Before peritoneum is closed

    

|waken the patient and have him cough and deep
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reathe
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The est results are achieved when the head of
    > the ed is elevated 45-90 degrees.
Muscle, fascia, su cutaneous tissue, skin
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Clear reath sounds Postoperative respiratory complications

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Inhale through the mouth and hold the reath for ) 
5 seconds and exhale through the mouth Slow, deep reaths to elevate the spirometer all

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    Increasing restlessness
Left foot is cold to touch and pedal pulse is
a sent ÷ 5
     
  
   
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     Instruct the client and monitor the use of the
Nerve and muscle damage incentive spirometer.

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  Pneumonia
Make sure the side rails are up
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Ê  Vaginal packing
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Curl the drain tightly and tape firmly to the ody. ÷ 5    
  
 
 
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  ÿemorrhage
Serous drainage
÷ 1     F8G 4


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÷ 7

 

       
  %  -  
    
/      Check the dressing for leeding
Turn the client to the operative side every 2-3
hours ÷ 4
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Pain with dorsiflexion of the foot
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Soft diet when fully awake Recent pelvic surgery

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For gastric decompression Tender, painful area on the leg

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        |m ulates frequently
|ssess the client for ladder fullness
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       Pink serous drainage


   
 
Urinary output of 20 ml/hr. ÷=  
  
+ %  
  
 
  
 

Coughing increases the risk of evisceration

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In a lateral position Cover the wound with sterile dressings saturated
with normal saline
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Prone with the head on pillow and turned to the Localized heat and redness
side
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÷    3      Wash hands
On the side of surgery
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   Clients who are undernourished
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Splinting the patient¶s chest with oth hands Serous drainage
during the exercises

Neuropathic
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    Pain that extends to near y tissues
Pain
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 '    | dominal cavity
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McCaffery ÷ 
     

|ssess pain as automatic as she assesses the
÷ 
  
  
 
     pulse and lood pressure.


   


Nociceptors ÷ 4
    
  
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|sk the client to point to the painful area y just
÷  
    
  
 
  one finger
3   
 
Believe what the patient says a out the pain
÷ 
  
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 Reassess the client appropriately to rule out
The client must e elieved a out perceptions of denial.
own pain.
÷ % 

  

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   /  /     ³Tell me what your pain feels like´
Consider the patient as the est authority on the
existence of the pain. ÷ .
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  Older patients seldom tend to report pain than the
Experienced reduce sensory perception younger ones (this is not a elief/myth, this is true)
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Patient¶s reaction to pain varies 
  ×
|re more sensitive to drugs
÷ 5
  

It is etter to wait until a client has pain efore ÷  
   

    
giving medication ecause client can validate its 

existence. Intensity
÷ =       

 
   
  ÷ 

   
 
 
+ %  ( Patient¶s description of the pain sensation
Pain tolerance
÷ %   
  %   
 


÷ 2
      
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  '
 
8

  
 
     |ggravating factor
Small nerve fi ers
 ÷     )
  

  ÊÊ Ê
 In your own words, tell me what your pain feels
÷ 5.,%
  
    
 
 
 
like
    
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Chronic
÷ 5
' 
   

  
 

Pain tolerance
÷ %       
  
Less than 6 months 

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Increase vital signs + diaphoresis |lleviating and relieving pain
÷    (
 
   
  
   ÷         5 +  
  
    
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Phantom pain    
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Client will return to functional status report
÷ ;4 
  
 
        

sta ilization of or improvement on comfort level.


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Referred pain ÷  
 
  
      

Reduce the client¶s perception of pain
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Cutaneous ÷   
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   Type of opioid eing used

 
    
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The client can distract himself during pain @F      
episodes E     


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r

 
Imagery is the use of the patient¶s imagination to
help control pain

÷ 1
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Stimulation of large diameter cutaneous fi ers to
lock the pain impulses from the spinal cord to the
rain



Ê  
÷ % =4.

  
     

  
 
General pain management choices ased on level
of pain



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9
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NS|IDS, acetaminophen (Tylenol)

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+ C 3  
 A + % '   
  A  +5+   ×
|t 11 pm

÷      


ÿydrocodone (step 2)

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Morphine, non-narcotic, TC|s

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Monitor VS, more importantly RR

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naloxone (Narcan)

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 |dminister their own analgesic
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Inhale through the mouth and hold the reath for
5 seconds and exhale through the mouth

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Powerlessness

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C- onstipation
P- ruritus (allergic reactions)
R- espiratory Depression)

÷       


Circulating Nurse

÷ 1 
  

Musculoskeletal and Neuropathic pain in origin

÷ 0   

  



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